Monthly Archives: November 2014

Undeserved free gifts – which reduce self sufficiency, discourage healthy lifestyles, & encourage excess.

Do we believe in “undeserved free gifts – which reduce self sufficiency, discourage healthy lifestyles, & encourage excess.” I believe patients and citizens should have responsibility for their own bodies, and the philosophy of “everything for everyone for ever” needs to be challenged. Why cannot these proposed services be linked to means, or volunteering, or exercise take-up, or a combination of these? Why can’t there be co-payments, if necessary on loans? Alcohol, obesity and poor sedentary and dietary lifestyles need to change, and “tablets for drinkers”, and “operations for obesity” are not going to help. They are perverse, in that they encourage the very behaviours we seek to change because patients feel they have a right to treatment. It is an emphasis on duties rather than rights, or individual and family responsibilities rather than expanded expensive services that is needed. The Regional Health Services will go bust, and those very services which are needed for cancer, stroke and heart diseases will be reduced, and waiting times increase, if we spend our limited funds chasing illusions.. I think I have answered a question NHSreality posed in an earlier post: What’s the opposite of “deserts based rationing”? Of course, commissioners in poorer areas (like Wales) will be unable to afford NICE recommendations compared to richer areas where the operations are needed less frequently!

BBC News reports 27th November 2014: NICE: Weight loss ops ‘good for obesity-linked diabetes’

The Independent 26th November 2014 reports: New £3 pill that will help stop you drinking too much available on the NHS

and Mark Lefty adds on the same day in the same paper: Alcohol is far more deadly than cannabis, former minister Norman Baker says 

John Bingham in The Telegraph 27th November 2014 reports: Childhood obesity surges between ages of seven and 11, study shows

Schools urges to step in as major study pinpoints obesity window between ages of seven and 11



Health services pay structures. Inequity and long-term mis management. Strikes and comparisons with politicians…

For The Independent, Alan Jones, on 25th November reports: NHS strike: Government accused of ‘lying’ about health service pay as nurses, midwives and ambulance staff stage four-hour walkout 

There is a problem with the different health services pay structures. The result of mis-management over many years has been inequity, inflated pay for managers, with annual increments and pay rises that, compounded make them receive much more in each rise than those on the lowest pay levels… Since these managers are considered no good to work outside the state, they stay on.. and on.. and on.. (The Guardian 8th October: Why are NHS staff going on strike?) Meanwhile, although England NHS has refused the rise, Scotland and Wales are implementing it. And does this approach justify receiving pay rises themselves… when they have large claimable overheads, (and choice of where to register as a patient)?

The Government has been accused of lying over NHS pay as hundreds of thousands of health workers including midwives, nurses, radiographers, cleaners and psychiatric staff stage their second strike in a month.

Members of 11 unions walked out for four hours from 7am in England and 8am in Northern Ireland in protest at the Coalition’s controversial decision not to accept a recommended 1% wage rise for all NHS employees.

Picket lines were mounted outside hospitals and ambulance centres, and the stoppage will be followed by a work to rule for the rest of the week.

A new row flared after the Government said it had put forward proposals to guarantee all staff would get at least 1% this year and next, but it had been rejected….

Meanwhile Walesonline reports: Assembly Members to get pay rise of £10,000 – Wales Online and even interviews We asked Wales’ 40 MPs about their 11% pay rise: Find out

Welsh NHS staff to receive ‘at least’ the living wage says

The Guardian 17th November: The NHS needs a 10-year funding commitment

Pay decisions announced for NHS staff and other public sector

We cannot afford a full health service. Dispute with drug company delays meningitis jab

Chris Smyth reports 25th November 2014: Dispute with drug company delays meningitis jab  In case NHSreality is new to you, we cannot afford a full health service….. I am in the process of buying my own Shingles Jab, as I am outside the funded scheme…. But for me, it’s worth it to know I have reduced the risk of this illness to a minimum..

Ministers have been accused of refusing to discuss the introduction of a life-saving vaccine as negotiations over the promised injection for meningitis B descend into acrimony.

The drug company that makes the vaccine says Whitehall is not returning its calls and that there has been no “meaningful negotiation” over the price of the jab, despite a pledge eight months ago that Britain would be the first to introduce it.

The accusation has angered officials, who said they would not be “held to ransom” by a company that wanted to use the spectre of dead children to extract money from the NHS.

David Cameron has taken a personal interest in the Bexsero vaccine, which protects against the strain responsible for more than half the 3,200 annual cases of meningitis. The main victims are children and young people. About one in ten die, with many others suffering deafness and brain damage.

Campaigners had assumed the delay was caused by wrangling over the price after government advisers doubted whether it would be cost-effective to inject every baby at a cost of hundreds of millions of pounds. However, Andrin Oswald, head of vaccines at Novartis, which makes Bexsero, said that officials had refused to discuss a price, and had not returned his calls for two months.

“We’re just waiting and waiting. I find it odd, given the sense of urgency everyone agrees there should be when this disease continues to kill and maim children,” he said. “To date I haven’t had meaningful discussions with government officials over . . . the prices.”

He added that he had proposed a figure lower than the £75 list price. Some regions of Italy, Germany and Canada have started a vaccination programme and Dr Oswald said that a million doses were ready for Britain.

Call for ‘Care First’ scheme to draft top young medics into poor areas

Jill Sherman in The Times 25th November reports: Call for ‘Care First’ scheme to draft top young medics into poor areas 

This is a good idea, and could be extended to provision of loans to undergraduates from less popular areas, provided they agree to work for 5 years as a graduate. Even better, only appoint graduates to medical school, and then we the citizen/taxpayer will get better value.. The local authority might help with housing as well. In Pembrokeshire the Hospital had 14 houses at it’s disposal when I arrived – a great help to new doctors in the area while they looked for a home.

Top medical graduates should be given incentives to work in hospitals in deprived areas under a “Care First” scheme to improve healthcare in poorer regions, a campaign group says today.

The proposal from Renewal, a centre right organisation, would build on Teach First, the two-year scheme which provides teacher training for bright graduates in some of the most deprived schools in the country.

The Care First plan would encourage medical graduates to work in hospitals or with GPs for two years in areas where there was a shortage of top doctors. Local hospitals in these areas would be able to bid for doctors from the new scheme, which would be run by the Government.

Details of the scheme have not been worked out but the government would give the brightest medical graduates financial incentives to join the scheme, such as having part of their student loan or their medical fees paid.

The proposal is the brainchild of David Skelton, founder of Renewal, who is looking at ways of attracting healthcare professionals to some of the worst hospitals in the country. It would also complement a plan announced by Norman Lamb, the health minister, to set up a fast track programme to train top graduates to work as mental health social workers.

Around 100 would-be social workers are to be recruited this year with the programme starting in 2016.

The medical Care First proposal, which has already been discussed with health officials, is to be part of Renewal’s manifesto for the Conservative party next May. “Far from being an issue the party should ignore, campaigning to boost the standard of healthcare – especially in the most deprived areas of the country – is directly linked to the Conservative’s long term economic plan,” said Mr Skelton.

“A strong economy is an absolute pre-requisite for a strong and well-funded health service. The Prime Minister has always been a firm believer in the NHS and this government has made it its mission to empower the patient,” he added.

Mr Skelton also called on a Conservative government to continue to phase out hospital car parking charges. While one in four hospitals no longer charge for parking some still set very high rates, he said. The Royal Free Hospital charged £3 an hour, or £72 a day, the Bristol Royal Infirmary charged £15 for 9 hours, while Luton and Dunstable Hospital charged £20 for more than 12 hours, he claimed.

The Department of Health said the mental health programme for social workers – entitled Think Ahead – was being developed with sector experts and mental health service users. “We know that social work can struggle to attract talented groups of people, particularly in mental health and we want to change this.”

Wales is so short of applicants. The Welsh Governement is going to fly them in..

“flying doctorsservice for Wales – Welsh Government

Graduates struggle to get mortgages as student loans soar

On November 18th on Factcheck Channel 4 Patrick Worrall’s program: FactCheck: is it still worth going to university?


Good News – If we can afford it. Gene linked to stroke at young age discovered

The Times reports Tuesday 25th November 2014: Gene linked to stroke at young age discovered

Good News – If we can afford it. The test might be given only to families at high risk because we cannot afford it for everyone..

Faithful to their genes - The Times

A gene that protects young and middle-aged adults from strokes has been discovered by British scientists.

People with the variant of the gene, Phactr1, are at reduced risk of suffering cervical artery dissection — a tear in an artery leading to the brain that can result in compression of adjacent nerves, blood clotting and then stroke.

The same gene variant has been identified as a protector against migraines and affects the risk of heart attack. The breakthrough offers hopes for treatments to prevent the major cause of strokes in young people.

About 152,000 people a year have a stroke in the UK and it is the third largest cause of death, after heart disease and cancer. Brain injuries caused by strokes are a major cause of adult disability.

Pankaj Sharma, professor of clinical neurology at the Royal Holloway, University of London, who was involved in the study, said the findings were an important breakthrough. The study in the journal Nature Genetics involved researchers worldwide screening the entire genome of 1,400 patients with cervical artery dissection, and 14,400 people without it.

The Genetic Literacy Project on November 14th 2014 reported from Canada: Gene patents pose challenge to doctors treating genetic disorders

In Canada, doctors are challenging legally-held patents on genes. The Children’s Hospital of Eastern Ontario has taken the case to the Federal court, citing barriers that gene patents present in providing tests for genetic diseases

via Chris Madden

Greater Manchester GP surgeries at breaking point after huge increase in patient numbers

David Otterwell and Dean Kirby report 5th November 2014 in a “Special report: Greater Manchester GP surgeries at breaking point after huge increase in patient numbers” 

Figures show that nearly 40,000 people have registered with doctors in the last 18 months. Look on the link for the actual numbers… The poor manpower planning and rationing of places for British students means we will be importing… for the next 3 – 4 elections..

GP surgeries are at breaking point after the number of patients across Greater Manchester soared by nearly 40,000 in just 18 months.

NHS data analysed by the M.E.N. shows that an extra 38,738 people signed up with a surgery from April last year to October this year.

The figures show that 16 surgeries in the region saw their registered patients increase by more than a quarter.


The number of extra people who signed up with a surgery from April last year to October this year


The average number of patients signed up with each surgery in Greater Manchester


The number of surgeries in the region which saw their registered patients increase by more than a quarter

One senior doctor says GPs are facing increasing pressure from rising numbers of patients due to an aging population and the movement of care out of hospitals.

Dr Kailash Chand OBE, a Tameside GP and deputy chairman of the British Medical Association, said the figures highlight the pressure on GPs.

He added: “There can be little doubt that GP practices across the north west are struggling with the same pressures that are coming to bare on GP services throughout the NHS.

“We are seeing serious shortfalls in the number of doctors choosing to train as GPs. In the north west, almost 30 per cent of GP trainee places went unfilled, while senior GPs are choosing to retire early or work abroad for a better work-life balance.

“If this situation continues, it will result in an accelerating decline in the overall number of GPs, which could present a threat to patient care as there may be too few GPs for the number of patients walking through the surgery doors.”

….A spokeswoman for NHS England in Greater Manchester said: “NHS England recognises the increase in patients registered with GPs in the Greater Manchester area.

“Continued growth in the local population has been anticipated and a number of new practices were established over recent years to accommodate some of these patients, while other practices have expanded.

“GP practices income is largely determined by their list size. Therefore, when the registered patient list grows, the practice receives an increase in funding to resource the increase in service delivery required for these patients.

“We can confirm that this will not affect patients’ ability to access appointments.”

Cradle to grave? Why the cost of dying is rising.

Richard Dyson reports in The Telegraph 24th Jan 2014: Why the cost of dying is rising so fast – Profit-driven crematoria and rocketing church fees are partly to blame

Some things should not be funded by the state, but the funerals of destitute people have to be…

The widely discussed problem of fuel poverty, when an increasing proportion of a household’s income is spent on energy, was trumped last week by another concept – funeral poverty.

The soaring cost of coping with the death of a family member is pushing more and more people toward state-aided funeral arrangements, according to a study by the University of Bath, published on Tuesday, and reported here.

There are two ways in which the state can help meet burial costs. The first is via a payout under the “Funeral Payments” system overseen by the Department for Work & Pensions (DWP). This is aimed at helping lower-income families meet burial costs of spouses or children. To qualify, families need to be receiving certain benefits….

….Consumer group Which? provides a range of information about funeral payment options. It includes the following insurance-based example, where “a 60-year-old man paying £15 a month to Legal & General would get £2,879 for a funeral after two years. After his 76th birthday, he’d have paid more than the policy covers and would have to continue paying until he died or reached 90.”

The NHS and ‘cradle to the grave’ | NHS reality. An NHS

Palliative and Terminal Care should be fully funded. | NHS

Everything for everyone forever? (Philosophy, honesty and

Public Health Funerals – Cornwall Council